Managing Conflicting Prognostic Communication Preferences in Pediatric Oncology

Area of Science:

• Pediatric Oncology
• Clinical Communication
• Qualitative Research

Background:

• Families of children with cancer have diverse preferences for receiving prognostic information.
• Clinicians require practical guidance to navigate these differing preferences while preserving trust and the therapeutic alliance.

Purpose of the Study:

• To gather recommendations from patients, parents, and oncologists on managing prognostic communication in pediatric oncology when family members have conflicting preferences.

Main Methods:

• A qualitative study involving semistructured interviews with 85 participants (25 patients, 40 parents, 20 oncologists) across 6 US cancer centers.
• Interviews explored communication experiences and recommendations, organized around core communication functions.
• Data were analyzed using rapid qualitative methods.

Main Results:

• Four key recommendations emerged: directly ask about preferences, collaboratively create communication plans, provide space for individual conversations, and respect parents' role in disclosure to children.
• Participants stressed the need for iterative, individualized communication strategies.
• Multidisciplinary collaboration is crucial for effective communication.

Conclusions:

• Participants identified practical approaches for clinicians to manage differing prognostic communication preferences in pediatric oncology.
• Findings support the development of training and interventions focused on flexible, family-centered dialogue.
• Effective communication strategies are vital for sustaining therapeutic alliances throughout serious illness.